Pre-Gait Training Option Within the Motion+ Software Suite

Pre-Gait Training Option Within the Motion+ Software Suite, Pre-Gait Training, Indego, ExoskeletonIndego’s Motion+ Software Suite offers a variety of unique features to provide a customized treatment approach. One of the newest Motion+ features offered is Pre-Gait Training. As the name implies, this feature was designed to be used prior to gait training for those persons who may benefit from activities in standing in preparation to walk. Patients can be challenged through the Pre-Gait Training option in both static and dynamic environments for exercise, neuro-reeducation, and/or functional mobility.

When incorporating Pre-Gait Training into your treatment session, patients should be positioned for safety, meaning in parallel bars, standing at a table or with a walker so that during the task they can quickly regain balance if needed. To increase the challenge of an activity, Indego Specialists can adjust levels of robotic assistance (Variable Assist) so that patients can target the work on their upper body, core or legs. Levels of Variable Assist may be applied to the left or right leg as well as to the hip or knee, depending on patient presentation.

Pre-Gait Training for those with weaker trunk and lower limbs

For patients who have absent or significant loss of trunk and/or lower extremity muscle function such as 0/5 to 2/5 manual muscle test (MMT), the Pre-Gait Training option combined with Variable Assist could be incorporated via

  • Pre-Gait Training Option Within the Motion+ Software SuiteStatic Standing Exercises with Double Stance Support.

    • Moving stability aid forward, backward, sideways left and sideways right

    • Ball toss (light or weighted)

    • Hand held or velcro closure arm weights

    • Thera-band, thera-tube or rope exercises

    • Reaching activities

    • Boxing

    • Static activities of daily living (ADLs)

    • Increase challenge with staggered stand foot position

Levels of Variable Assist would be selected based on how much you want to challenge the user. Typically for this group, the range of Variable Assist would be anywhere from 100% to 50%.

Pre-Gait Training for those with stronger trunk and lower limbs

For patients who have stronger trunk and/or lower extremity muscle function such as 3/5 to 5/5 manual muscle test (MMT), the Pre-Gait Training option combined with Variable Assist may be incorporated via

  • Pre-Gait Training Option Within the Motion+ Software SuiteStatic Standing Exercises with Double Stance Support

    • Similar activities listed earlier, but with lower levels of robotic assistance

  • Dynamic Standing Exercise with Single Stance Support​

    • ​In order to actively move a single leg for exercise, the Variable Assist must be 0% to 20% throughout the limb. Otherwise it will be too difficult to move the leg individually.

    • Stepping on/off various platform heights

    • Stepping small ranges into abduction and adduction

    • Single leg stepping forward and backward

    • Weight shifting side to side with single leg lifts

Levels of Variable Assist would be selected based on how much you want to challenge the user. Typically for this group, the range of Variable Assist would be anywhere from 100% to 0%.

Documenting change

Patient progress can be objectively measured and documented using the following:

  • Reduction in the Variable Assist settings (for example, decreasing Variable Assist from 100% to 50% to 10% for any of the joint options).

  • Level of physical assist provided by the Indego Specialist for the patient to complete the task

  • Time that the patient tolerates a certain exercise or can maintain a certain position

  • Strength of the thera-band/thera-tube tolerated

  • Heaviness of the arm weights

  • Distance the patient was able to reach (Functional Reach Test)

  • Continuous boxing time

  • Height of the platform onto which the patient was able to step up and step down

  • Ability to add more complexity to the exercise (for example reducing Variable Assist from a unilateral hip joint to bilateral hip joints, or more than one joint such as both the hip and knee)

The Pre-Gait Training feature under the Motion+ Software Suite provides clinicians with a customized approach for enhancing functional outcomes. Have fun and please share your creative ideas!

 

Pre-Gait Training Option Within the Motion+ Software Suite, Clare Hartigan, PT, MPT, Shepherd CenterThis article was contributed by Clare Hartigan, PT, MPT. Clare is the Program Manager for Lower Extremity Robotics at The Virginia C Crawford Research Institute, Shepherd Center. Clare received her Bachelor of Science in Biology, Cum Laude, from Bucknell University in 1986 and a Master in Physical Therapy, Highest Honor, from Emory University in 1989. She has been working in the field of neurologic rehabilitation her entire career. Since 1991, she has been employed at Shepherd Center and served multiple roles as a clinician, supervisor/manager and researcher. Her work with exoskeletons began in 2010 trialing patients with Esko, ReWalk and Indego exoskeletons. Clare has conducted Indego research from 2010 to the present. Currently as a Certified Indego Instructor, Clare has travelled across the world educating and teaching others about exoskeleton technology. Clare is a member of the American Physical Therapy Association and the Neurologic Section.

 

Pre-Gait Training Option Within the Motion+ Software Suite, Shepherd Center, Indego, Exoskeleton

 

Shepherd Center, located in Atlanta, Georgia, is a 152 bed, private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury and multiple sclerosis.

 

 
 
 
 

Related content:

Introduction to Indego Motion+ and Therapy+

10 Meter Walk Test for Indego Exoskeleton

What to Consider When a Rehab Center Wants to Invest in Advanced Technology

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